Holiday season can be a challenge to maintaining a healthy lifestyle. Incorporating the following healthy behaviors can help you navigate through the common land mines, not only during the holidays, but all year long.

Many people with diabetes feel alone in their journey, but it doesn’t have to be that way. Nancy Barton, RN, CDE, profiles the players on your diabetes support team and how they address different aspects of your experience.

It's the beginning of the New Year - the perfect time to review what you are already doing to take care of your diabetes and what changes you can make to manage it better. Most Year Year's resolutions begin with a great start, but often fail due to lack of motivation or burnout issues. Managing diabetes is not easy, especially with the many roadblocks that one may face. When trying to make a lifestyle change, one of the biggest challenges of individuals with diabetes is not knowing how to set appropriate goals. Here are some tips to help you be successful in implementing lifestyle changes:

1) Set up a goal: As you work on setting your goals, it is important to set specific and realistic goals. A specific goal has a greater chance of being accomplished than a general goal because you know the behavior you would like to change and the estimated time-frame needed to achieve the goal. Goals such as, "I will eat three servings of vegetables at least 6 days a week," are more specific and realistic than, "I will eat more vegetables every day." Another example might be, "five days a week I will walk for 20 minutes after dinner," rather than saying "I will walk everyday."

It always helps to have the goal written down as a visual reminder. This means you could write it on a sticky-note and place it somewhere you can see it multiple times a day; or you can set reminders on your phone, tablet, or daily personal calendar.

Once you have set a goal and have been successful in its implementation, you can advance the goal. You can now say, "I will eat four servings of vegetables everyday," or, "five days a week, I will walk for 30 minutes after dinner."

2) Have a Plan: Now that you have set goals to work on, set a time frame for implementing them. You also want to think about barriers that may prevent you from accomplishing your goals. Barriers may include something like not having the time to prepare recipes that include more vegetables. You could work around that by buying more frozen vegetables or salads and you can revamp your traditional recipes to make them easier and quicker to prepare.

3) Implement your Plan: Have a daily log that helps you track changes you have already implemented.

Remember that in spite of your best possible efforts, there may be days when you are not able to follow through on your goals. That's OK, as long as you don't lose sight of the bigger picture.

Now that you have set some realistic, achievable goals and have actually implemented them, it's time to reward your accomplishments. It is important that the goal is relevant to you and that you have a reward and recognition system in place. You want to reward yourself with something that is appropriate to what you have accomplished. It needs to be affordable, available soon enough after successful implementation, and valuable and meaningful to you.

In addition to specific goals you may want to implement, here are some general goals to help keep your diabetes under check:

Follow-up with your Healthcare Provider 3-4 times per year and more often if situations arise

Check your blood sugars daily

Take your medications as prescribed

Check your feet daily

Schedule an appointment with the dentist twice a year and an annual comprehensive eye exam

Why people think they’re healthy: “Free” implies that bad things are removed from foods, so it would seem these foods would then be healthy and therefore there is no need to limit portions.

Why that’s not necessarily so: People with celiac disease cannot process gluten (found in wheat, rye, barley, bulgur, graham, and spelt) however most people can. Someone may experience a benefit from cutting gluten from their diets only because they are cutting down on carbohydrates, but this often can go too far. Someone who goes “gluten free” has to become really conscious of including whole grains in the diet (such as rice [especially brown], corn, quinoa, millet, buckwheat, gluten-free oats) because of their nutritional contributions and importance to overall health. Carbohydrates should provide 45 - 65% of total calories daily per the Dietary Guidelines for Americans. Many foods made without fat or sugar will have more of the other in order to make them taste better, which still renders them to be unhealthful. The manufacturers are going to put something in to make sure people like their products! Calorie balance always comes into play with portions, as well.

Health Drinks and Health Bars

Why people think they’re healthy: Popular electrolyte-replacement drinks replace fluids and provide “energy”; protein bars are formulated to have protein and “energy”.

Why that’s not necessarily so: The “energy” from these foods is provided by carbohydrates (mostly sweeteners) and some vitamin-containing “waters”; plus they often provide caffeine. Electrolyte drinks provide fluids and energy for vigorous workouts, however they are not healthy for casual drinking when compared to plain water, 100% fruit juices, or milk. “Health bars” are often candy bars with added oatmeal or other grains, and nuts. Advise people to read labels to see the sugar and fat content of these heavily marketed products. Suggest they consider a switch to making smoothies which contain whole fruits, vegetables and milk or yogurt for a healthy drink or snack.

Vegetarianism

Why people think it’s healthy: Aren’t we supposed to eat more vegetables?

Why it’s not necessarily so: The problem for many people is that being a vegetarian is more about giving up “meat” and less about eating enough volume or variety of vegetables and fruits. A diet based on pasta and cheese or nuts and soy can be quite unhealthful due to its limited nature. Vegans in particular are at risk of not getting enough protein and calcium, and should take B-12 supplements because this nutrient can only be found in animal proteins such as meat, dairy, eggs, and fish. Further, vegetarians still need to focus on getting a balanced diet—fresh fruits, vegetables, and whole grains, and encouraged to consume low fat dairy as well.

Wine

Why people think it’s healthy: Many studies tout that wine is healthy and beneficial, showing that wine’s alcohol and polyphenols, especially resveratrol from grapes, appear to reduce LDL (“bad”) cholesterol and increase HDL (“good”) cholesterol. Wine also provides antioxidants which can be helpful in preventing some diseases.

Why it’s not necessarily so: Many of the studies on wine have been conducted on animals, or look at correlations, and are not necessarily true for humans. Plus, some of the benefits of wine can be found in grapes themselves, and in other fruits and vegetables. The recommended daily limit of one glass for a woman, two for a man is not often followed in real life. Moderation is the key. Other research has also demonstrated that wine is unhealthy. Too much can lead to high blood pressure, increased triglycerides, and cancer. Wine is also not recommended during pregnancy.

Foods People Often Think Are An Indulgence, But May Be Good For You

Coffee

Why people think it’s an indulgence: It’s “addictive”, it interferes with sleep, and people love it so much it must be bad.

Why it’s pretty healthful: True, overindulgence can create problems for some such as affecting blood pressure or interfering with sleep. Current research continues to provide evidence for new ways that caffeine is beneficial to health. Contributing to the major reasons coffee was deemed unhealthy in past decades was that people who smoked, exercised little, ate unhealthy diets, and also drank coffee resulted in coffee being blamed for years for high cholesterol, obesity and other problems when in fact the accompanying habits were the culprits. Coffee seems to be protective against Parkinson’s disease, Type 2 diabetes, and liver disease including liver cancer (Mayo Clinic). Neurologists have determined that coffee has a role in improving cognitive function and decreasing the risk of depression. The key again is moderation, as well as moderating the added cream and sugar.

Eggs

Why people think they are an indulgence: Eggs contain cholesterol, and for many years cardiologists pinpointed eggs as being especially detrimental to heart health.

Why they’re pretty healthful: Eggs do contain cholesterol, however even people with high cholesterol do not have to avoid them completely or even limit themselves to the whites. Eggs are an excellent source of protein, and the yolks offer minerals (zinc, iron) as well as choline, vitamin A, and B-vitamins which are essential to normal cell processes in the body.

Chewing Gum and Mints

Why people think they are an indulgence: Aren’t they essentially candy?

Why they’re pretty healthful: The sugar alcohol Xylitol in some sugarless gums and mints is actually beneficial to the teeth. Xylitol prevents cavity-causing bacteria from adhering to teeth and can help build enamel. Xylitol should be listed in the first three ingredients for gum or mints. It can be beneficial to take the gum or mints after eating sugary or acidic foods at times when you don’t brush your teeth.

Resources:

Academy of Nutrition and Dietetics. www.eatright.org. Accessed December 3, 2015.

With the holidays right around the corner, keeping blood sugars in control can be somewhat of a challenge. Whether you’ve “fallen off the bandwagon” in the past or done a relatively good job eating healthy, the following suggestions may help you get through the holidays without cramping your lifestyle.

Always take your medications. Be sure to stay on a schedule with your medications and don’t forget them if you are traveling away from home. Don’t be embarrassed about having to take medications in front of family or friends. You can always excuse yourself and go to another room to check blood sugars and take medications. Most people will understand or won’t even notice.

Keep checking blood sugars as instructed by your doctor. When eating different foods and doing different activities you may find that managing blood sugars can be a bit more challenging. Continuing to check blood sugars is critical to staying in control.

Carry glucose tabs or another form of fast-acting sugar with you. As mentioned above, by doing other activities you may be more likely to have unexplained high or low blood sugars. Have a form of fast-acting sugar on hand in case of a low (e.g., glucose tabs).

Get some form of physical activity every day. Go for a walk after dinner, play with the kids, go dancing, etc. The holidays can bring many opportunities for activity with loved ones.

Eat a healthy snack before going to a party to avoid overeating unhealthy foods. When you are hungry you are much more likely to make unhealthy food decisions and temptations can be harder to resist. If you show up not hungry you are much more likely to resist those yummy temptations.

Find out what will be served before going to a party to plan it into your meal plan. There is no need to feel shy about asking the host of a party what will be served before showing up. When you know what will be served you can decide beforehand what you will eat and won’t have to make a decision in the moment (as it may be harder to make a healthy one).

Bring a healthy dish to a party to share with others! You can always bring something you can eat, and others will most likely appreciate it as well. With 1 in 11 Americans having Type 2 diabetes, and more than 1 in 3 having Pre-Diabetes (2), you aren’t alone!

While socializing, go to a room where the food isn’t being served to avoid snacking. Get yourself out of temptation’s way. If after a while of being away from it for a while and you want to eat, you can go back and consciously eat.

Choose low or no carb drinks such as sparkling water, unsweetened tea, or diet beverages. An easy way to avoid too many carbs is by avoiding sugary drinks. High sugar drinks can quickly put you over your carb limit.

Make the focus of your festivities people and activities instead of food. The holidays aren’t just about food. Enjoy the relationships you have and don’t be scared to strengthen them during the holidays.

When eating, focus on vegetables and protein before carbs. When loading up your plate, be aware of what has carbs and what doesn’t, to avoid setting yourself up for failure.

Don’t overeat. You’ll thank yourself later

Plan ahead if you will be traveling. Keep in mind different time zones, availability of a refrigerator and medications. Talk to your health care provider with more specifics if you are concerned.

Be wary of treats brought over by friends and neighbors. The holidays can be a time for baked sweets and sharing them. Graciously thank others for their thoughtfulness but don’t allow yourself to lose control. Plan treats into your meal plan if possible, and give the rest to someone who may want them.

Remember, the holidays are for enjoying and growing closer to others and not just about the food. By having good control of your Diabetes during the holidays, you will feel better and have better BGs without any regret (3).

References:

1. “Managing Your Diabetes During the Holidays.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 17 Nov. 2014. Web. 14 Nov. 2015.

2. “2014 National Diabetes Statistics Report.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 15 May 2015. Web. 14 Nov. 2015.

Are your patients having trouble sticking to their diet? Do they struggle to make sense of all of the nutrition information they see on TV, in magazines, books and from friends? There is so much nutrition information around us that it is a challenge to stay on top of the latest recommendations. It is understandable that many patients feel overwhelmed with it all and give up.

My philosophy regarding nutrition is to keep it simple. I don’t believe that eating needs to be confusing and a constant challenge. If something comes from the ground, a tree or an animal and is not processed or minimally processed it is good for you. The idea that a banana might be bad for you or a potato is just confusing and not based on science. All whole foods like fruits, vegetables, grains, meats are inherently healthy for you. They have natural vitamins and minerals and are full of nutrients important for your body. Of course the portion size of any food is still important and something almost everyone can work on.

When I work with people who have diabetes, I start with finding out what their current eating patterns are like, and then we move towards some areas they are willing to work on. Typically, people think that I am going to tell them that they must eliminate all of their favorite foods and never eat things like bread, pasta, potatoes and sweets again. This is definitely not the case, and so it is exciting to see them brighten up as they learn all foods can fit into a healthy diet. I emphasize instead the importance of portion size, balance and variety. I also encourage patients to try and incorporate some healthy carbohydrates that maybe they haven’t tried before such as quinoa, faro, barley, beans, lentils, and Greek yogurt to name a few. I also drive home the value of vegetables as a low carbohydrate, high fiber and nutrient dense food group. When they see a portion of pasta compared to the equivalent vegetable portion they are usually amazed. With the patient, we collaboratively discuss ways they can include more whole grains and vegetables into their diet and plan ahead for meals and snacks so they have healthy and tasty foods available.

Recently, a patient told me she had never been able to stick to the “diabetic diet” after having diabetes for many years. She had given up on the diet because she didn’t understand it and wasn’t sure what a “carb choice” was. We reviewed carbohydrate foods and their effect on blood sugar as compared to fats and protein. We then discussed her current eating habits and she suggested that she could work on eating a few more vegetables and less crackers and pasta. At her next visit she was able to say with confidence that she had been able to follow what we discussed much of the time and was noticing a change in her blood sugars.

I really believe that no matter your diagnosis, eating should be fun and enjoyable and doesn’t have to be confusing. Eating plans can be flexible and should be something that makes sense for your lifestyle most of the time. Our patients will have much better success sticking with lifestyle changes if we can keep the messages related to nutrition simple and practical. I’d love to hear how you are able to keep nutrition simple as an educator or a patient.